Prevention of suicidal behavior

More than 800 000 people die every year from suicide, and about 20 times more attempt suicide. In most countries, suicide risk is highest in older males, and risk of attempted suicide is highest in younger females. The higher lethal level of suicidal acts in males is explained by the preference for more lethal methods, […]

Reducing suicide without affecting underlying mental health: Theoretical underpinnings and a review of the evidence base linking the availability of lethal means and suicide (IN: The International Handbook of Suicide Prevention, 2nd ed., edited by R. C. O’Connor & J. Pirkis)

This chapter provides a synthesis of the empirical literature that assesses the relationship between ready access to highly lethal means of suicide and overall suicide rates. It lays out the theoretical underpinnings of the assertion that reducing access to lethal means of suicide can reduce suicide rates. The most convincing evidence that restricting access to […]

Three leading suicide methods in the United States, 2017–2019: Associations with decedents’ demographic and clinical characteristics

Background and aims: The U.S. suicide data show that use of lethal methods, specifically firearms and hanging/suffocation, has been increasing among young and middle-aged adults of both sexes over the past decades. In this study, we examined demographic and clinical correlates of use of firearms, hanging/suffocation, and poisoning as suicide methods among suicide decedents age 18+. […]

Frequency of clinicians’ assessments for access to lethal means in persons at risk for suicide

Objective We measured the frequency of clinicians’ assessments for access to lethal means, including firearms and medications in patients at risk of suicide from electronic medical and mental health records in outpatient and emergency settings. Methods We included adult patients who reported suicide ideation on the PHQ-9 depression screener in behavioral health and primary care […]

Lethal means assessment in psychiatric emergency services: Frequency and characteristics of assessment

Objective Lethal means safety is an effective suicide prevention strategy with demonstrated results at the population level, yet individual-level uptake is less well understood. Methods Using automated data extraction methods, we conducted an investigation of electronic health records from psychiatric emergency service (PES) patients from January 1, 2012 to December 31, 2017 at a busy […]

Attempted suicide: Does lethality matter?

Objectives: To investigate whether high-lethality suicide attempters align to the demographic and clinical features observed in completed suicide in the national and international literature, and whether low-lethality attempters more closely align with the clinical profile of non-attempter ideators. Methods: A retrospective chart review of adult suicide ideators and attempters presenting to an urban tertiary care […]

The serious suicide attempts approach for understanding suicide: Review of the psychological evidence

The study of survivors of a serious suicide attempt (SSA)––an attempt that would have been fatal had it not been for the provision of rapid and effective emergency treatment––can help researchers understand the suicidal mind. Serious suicide attempters are epidemiologically very similar to those who died by suicide, and thus can serve as valid proxies for studying […]

Trends in the incidence and lethality of suicidal acts in the United States, 2006 to 2015

IMPORTANCE Understanding changes in the incidence rates and lethality of suicidal acts may explain increasing suicide rates. OBJECTIVE To examine trends in the incidence rates and lethality of suicidal acts from 2006 to 2015 among persons aged 10 to 74 years. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional study was conducted from May 2, 2018, to […]

Trends in the incidence and lethality of suicidal acts in the United States, 2006-2015

Importance  Understanding changes in the incidence rates and lethality of suicidal acts may explain increasing suicide rates. Objective  To examine trends in the incidence rates and lethality of suicidal acts from 2006 to 2015 among persons aged 10 to 74 years. Design, Setting, and Participants  This cross-sectional study was conducted from May 2, 2018, to January 30, 2019. […]

What are reasons for the large gender differences in the lethality of suicide acts? An epidemiological analysis in four European countries

BACKGROUND: In Europe, men have lower rates of attempted suicide compared to women and at the same time a higher rate of completed suicides, indicating major gender differences in lethality of suicidal behaviour. The aim of this study was to analyse the extent to which these gender differences in lethality can be explained by factors […]

Lethality of previous suicidal behavior among patients hospitalized for suicide risk predicts lethality of future suicide attempts

Objective A suicide attempt is an established risk factor for subsequent suicide attempts and suicide. Nonetheless, the prediction of future suicidal behavior is poor. The lethality of previous suicidal behavior may be informative to better understand future suicide risk among patients hospitalized for suicidal thoughts and behavior. The current study examined whether the lethality of […]

Frequency of lethal means assessment among emergency department patients with a positive suicide risk screen

Prior work from surveys and limited populations suggests many emergency department (ED) patients with suicide risk do not have documented lethal means assessments (e.g., being asked about home firearms). The specific objectives of this study were to, in an ED with universal screening for suicide risk: (1) estimate how often ED providers documented lethal means […]

Rethinking lethality in youth suicide attempts: First suicide attempt outcomes in youth ages 10-24

Objective Although suicide is the second most frequent cause of death in American youth, suicide research has heretofore been confined to convenience samples that represent neither psychiatric nor general populations and that fail to include individuals dying at their first attempts. These limitations were addressed by assembling a youth cohort followed from the first medically recorded attempt […]

Deaths due to use of lethal force by law enforcement: Findings from the National Violent Death Reporting System, 17 U.S. States, 2009-2012.

INTRODUCTION: Several high-profile cases in the U.S. have drawn public attention to the use of lethal force by law enforcement (LE), yet research on such fatalities is limited. Using data from a public health surveillance system, this study examined the characteristics and circumstances of these violent deaths to inform prevention. METHODS: All fatalities (N=812) resulting […]

Is there a relationship between suicidal intent and lethality in deliberate self-poisoning?

The relationship between suicidal intent and lethality of deliberate self-poisoning (DSP) episodes and their associations with suicide have yielded contradictory findings. The aims of this study were to investigate the association between patients’ suicidal intent and independently rated lethality of DSP episodes, and whether the association changes over time. Eighty-nine DSP patients were investigated longitudinally. Self-reported suicidal […]

Suicide intent and accurate expectations of lethality: Predictors of medical lethality of suicide attempts.

The degree of intent to commit suicide and the severity of self-injury were examined in individuals (N = 180) who had recently attempted suicide. Although a minimal association was found between the degree of suicide intent and the degree of lethality of the attempt, the accuracy of expectations about the likelihood of dying was found […]

Serious suicide attempts: Toward an integration of terms and definitions.

Suicidal behavior comprises a diverse set of behaviors with significant differences among several behavioral categories. One noteworthy category includes individuals who have made serious suicide attempts, epidemiologically very similar to those completing suicide. This behavioral category is important, since interviewing survivors of a potentially lethal incident of self-harm enables a detailed investigation of the psychological […]

Analysis of the cost effectiveness of a suicide barrier on the Golden Gate Bridge.

The Golden Gate Bridge (GGB) is a well-known Òsuicide magnetÓ and the site of approximately 30 suicides per year. Recently, a suicide barrier was approved to prevent further suicides. Cost-benefit analysis suggests that a suicide barrier on the GGB would result in a highly cost-effective reduction in suicide mortality in the San Francisco Bay Area.

Mental pain, communication difficulties, and medically serious suicide attempts: A case-control study.

Medical severe suicide attempts (MSSA) are epidemiologically very similar to individuals who complete suicide. Mental pain variants (e.g., hopelessness), facets of communication difficulties (e.g., self-disclosure), as well as socio-demographic and clinical characteristics were assessed. The MSSA had significantly higher communication difficulties than the other 3 groups. Moreover, the interaction between mental pain and communication difficulties […]

Age of first suicide attempt in men and women: An admixture analysis


Involvement in Physical Activity and Risk for Nearly Lethal Suicide Attempts

This study compared reports of recent physical activity among those surviving a nearly lethal suicide attempt to reports from community controls. Analyses were conducted on data collected between November 1992-July 1995 for a study of nearly lethal suicide attempts among people aged 13-34 years. Logistic regression analyses were used to test the association between suicide […]

Prison Inmate Characteristics and Suicide Attempt Lethality: an Exploratory Study

This exploratory study applied a continuous rating scale of suicide attempt lethality to incidents where an inmate survived a suicide attempt. It describes the attempt incident dynamics & resulting range of lethality scores found within the study sample. It also examines the inmate adjustment & mental health characteristics that were associated with the lethality rating. […]

Pathways to High-Lethality Suicide Attempts in Individuals With Borderline Personality Disorder

This study developed & tested a model of high-lethality suicide attempts in individuals with borderline personality disorder. An increased number of prior suicide attempts, substance use immediately prior to the attempt, & objective planning were proposed to lead directly to a high-lethality suicide attempt, while aggression & impulsivity were hypothesized to lead indirectly to a […]